Abstract
Background: Infectious disease outbreaks remain a persistent public health threat in Malawi. The 2022–2024 polio outbreak highlighted the central role of enhanced surveillance in timely detection and effective response. This abstract examines key strategies, outcomes, and lessons for strengthening surveillance and preparedness.
Methods: The response leveraged multiple surveillance approaches, including Acute Flaccid Paralysis (AFP) and environmental surveillance, improved specimen transport, digital tools for case investigation, and multiple supplementary immunization campaigns. Data from surveillance indicators and outbreak response activities were analyzed to assess performance and identify challenges.
Results: Enhanced surveillance proved effective, with rapid laboratory confirmation of the index case triggering activation of the Emergency Operations Centre and nationwide vaccination campaigns. Integrated supportive supervision using digital platforms improved timeliness of AFP reporting, increasing detected cases from 397 in 2021 to 516 in 2023. Surveillance indicators improved markedly: the non-polio AFP rate rose from 2.1 (2021) to 6.7 (2023), and stool adequacy from 80% to 91% over the same period. Environmental surveillance further strengthened early detection, complementing AFP systems. Additionally, surveillance captured non-polio enteroviruses (increasing from 4% in 2021 to 12% in 2023) and measles cases, demonstrating broader system benefits. Despite these gains, challenges persisted, including vaccine hesitancy due to repeated campaigns, limited real-time data sharing, and inadequate in-country laboratory capacity
Conclusion: The polio outbreak response underscores the importance of robust, multi-layered surveillance systems. Strengths included improved timeliness, expanded disease detection, and integration of digital tools, while gaps in laboratory capacity and community engagement hindered efficiency. Moving forward, Malawi should prioritize investments in real-time digital health platforms, strengthen laboratory systems, and build trust through community engagement. Such measures will reinforce resilience against future outbreaks and protect vulnerable populations.
Notes
References:
Chunda, P., Chimunda, I., & Ngwira, B. (2022) ‘The 2022 Malawi polio outbreak: what next?’, Public Health Practice, 3, 100279.
Kazanga-Chiumia, I. (2022) ‘Malawi polio outbreak: What next?’, Public Health Practice, 3, 100279.
McCarthy, K. (2022) ‘The show is not over – wild-type polio in Malawi is a wake-up call and an opportunity for elimination efforts’, International Journal of Infectious Diseases, 122, pp. 394-397.
Ministry of Health Malawi,Public Health Institute of Malawi (2023) Polio Outbreak Stuation Report EPI Week 47.
Gwinji, P.T. et al. (2022) ‘The re-emergence of wild poliovirus type 1 in Africa and implications for surveillance and outbreak response’, EClinical Medicine, 45, 101330.
Sigma Membership
Chi Xi at-Large
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Public and Community Health, Primary Care, Sustainable Development Goals, Disease Management, Public Health, Disease Outbreaks, Public Health Surveillance, Polio Prevention, Malawi
Recommended Citation
Dembo, Zione N.; Chisema, Mike Nenani; Beyamu, Joyce; and Nazimera, Tamandani Kapenga, "Strengthening Disease Surveillance in Malawi: Lessons from the 2022 Polio Outbreak" (2026). International Nursing Research Congress (INRC). 63.
https://www.sigmarepository.org/inrc/2026/posters_2026/63
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-10
Strengthening Disease Surveillance in Malawi: Lessons from the 2022 Polio Outbreak
Toronto, Ontario, Canada
Background: Infectious disease outbreaks remain a persistent public health threat in Malawi. The 2022–2024 polio outbreak highlighted the central role of enhanced surveillance in timely detection and effective response. This abstract examines key strategies, outcomes, and lessons for strengthening surveillance and preparedness.
Methods: The response leveraged multiple surveillance approaches, including Acute Flaccid Paralysis (AFP) and environmental surveillance, improved specimen transport, digital tools for case investigation, and multiple supplementary immunization campaigns. Data from surveillance indicators and outbreak response activities were analyzed to assess performance and identify challenges.
Results: Enhanced surveillance proved effective, with rapid laboratory confirmation of the index case triggering activation of the Emergency Operations Centre and nationwide vaccination campaigns. Integrated supportive supervision using digital platforms improved timeliness of AFP reporting, increasing detected cases from 397 in 2021 to 516 in 2023. Surveillance indicators improved markedly: the non-polio AFP rate rose from 2.1 (2021) to 6.7 (2023), and stool adequacy from 80% to 91% over the same period. Environmental surveillance further strengthened early detection, complementing AFP systems. Additionally, surveillance captured non-polio enteroviruses (increasing from 4% in 2021 to 12% in 2023) and measles cases, demonstrating broader system benefits. Despite these gains, challenges persisted, including vaccine hesitancy due to repeated campaigns, limited real-time data sharing, and inadequate in-country laboratory capacity
Conclusion: The polio outbreak response underscores the importance of robust, multi-layered surveillance systems. Strengths included improved timeliness, expanded disease detection, and integration of digital tools, while gaps in laboratory capacity and community engagement hindered efficiency. Moving forward, Malawi should prioritize investments in real-time digital health platforms, strengthen laboratory systems, and build trust through community engagement. Such measures will reinforce resilience against future outbreaks and protect vulnerable populations.
Description
The 2022–2024 polio outbreak in Malawi highlighted the importance of strong disease surveillance systems. Enhanced AFP and environmental surveillance, digital reporting tools, and rapid response mechanisms improved case detection and outbreak control. Despite progress, challenges such as vaccine hesitancy, limited data sharing, and weak laboratory capacity remain, underscoring the need for sustained investment in surveillance and community engagement.